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Graft-Versus-Host Disease (GVHD)

  • Chapter
A Guide to Blood and Marrow Transplantation

Abstract

With a successful transplant of hematopoietic stem cells, the recipient’s lymphohematopoietic system is replaced by donor-derived cells. Thus, in contrast to solid organ transplantation where the recipient’s immune system remains in place and immunosuppression is aimed at preventing the reaction of recipient cells against the transplanted organ (i.e. rejection), a double-barrier exists in hematopoietic transplantation: 1) transplanted stem cells may fail to reconstitute successfully hematopoiesis in the recipient (graft failure due to immunological or other mechanisms; III.2) and 2) donor lymphocytes may attack recipient tissue leading to GVHD. While graft failure has generally occurred mainly after HLA incompatible transplants, with T-cell depletion and in patients allosensitized by prior transfusions, GVHD has been a major problem with all allogeneic transplants. Presumably, in all instances of hematopoietic stem cell transplantation an interaction between donor and host cells (graft-vs-host reaction) takes place, although generally there are no clinical manifestations of it after syngeneic (i.e. genetically identical) or autologous (i.e. the patient’s own) stem cell infusion.

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  1. H. J. Deeg
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© 1999 Springer-Verlag Berlin Heidelberg

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Deeg, H.J. (1999). Graft-Versus-Host Disease (GVHD). In: A Guide to Blood and Marrow Transplantation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18248-8_14

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  • DOI: https://doi.org/10.1007/978-3-642-18248-8_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62122-2

  • Online ISBN: 978-3-642-18248-8

  • eBook Packages: Springer Book Archive

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